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The burdensome costs of medical care, prescription drugs and health insurance have become dominant issues in the 2020 presidential campaign. But a new report from the Department of Health and Human Services shows the nation remains in a period of relatively slow growth in health spending. Health spending in the United States rose by 4.6 percent to $3.6 trillion in 2018 — accounting for 17.7 percent of the economy — compared to a growth rate of 4.2 percent in 2017. Federal officials said the slight acceleration was largely the result of reinstating a tax on health insurers that the Affordable Care Act imposed but Congress had suspended for a year in 2017. Faster growth in medical prices and prescription drug spending were also factors, they said, but comparatively minor. (Goodnough and Sanger-Katz, 12/5)

The federal government and households were the largest sponsors, each contributing 28% to the total spending in the year. The cost of health as a share of the economy decreased 0.2 points to 17.7% in 2018. Increased net costs drove up private health insurance spending by 5.8% to $1.2 trillion in 2018, faster than the 4.9% growth in the year before. (12/5)

Private businesses, meanwhile, shelled out nearly $727 billion on health care, an increase of 6.2% -- the fastest growth rate since 2003. More than three-quarters of that spending is on employer contributions for insurance premiums, which rose at a quicker pace than in 2017. Spending by Medicare, Medicaid and private health insurance grew faster in 2018 partly because of the reinstatement of the health insurance tax, an Affordable Care Act provision that Congress suspended for 2017. The tax was expected to raise $14.3 billion in 2018, according to the Internal Revenue Service. (Luhby, 12/5)

Between the lines: U.S. health care spending climbed again not because people went to the doctor or hospital more frequently, but because the industry charged higher prices. And private health insurers didn't do a particularly good job negotiating lower rates. (Herman, 12/5)

The number of people without insurance rose by 1 million in 2018 for the second consecutive year, with 30.7 million individuals uninsured. Democrats have criticized Mr. Trump for his efforts—including ending billions of dollars in payments to insurers and expanding health plans that are cheaper but don’t provide the health law’s consumer protections—to roll back the 2010 Obama-era health law that expanded coverage to an estimated 20 million people. While the overall acceleration in national health-care spending wasn’t that large relative to other years, an Affordable Care Act tax accounts for most of the increase, according to the report. The tax, an annual fee on all health insurers, is among several imposed under the law to cover its estimated 10-year cost of more than $1 trillion. (Armour, 12/5)

Prices for prescription drugs edged down by 1% last year, a rare result driven by declines for generics and slow, low growth in the cost of brand-name medications, the government said Thursday. Though modest, it was the first such price drop in 45 years, according to nonpartisan economic experts at the federal Department of Health and Human Services, who deliver an annual report on the nation's health care spending. (Alonso-Zaldivar, 12/5)

The slowing of drug price increases “means buyers are being smarter and more sensitive” looking for generic alternatives and other ways to avoid high-priced medicines, said Dan Mendelson, founder of Avalere Health, a D.C.-based consulting firm. “It’s tempting to declare victory when spending growth attenuates,” Mendelson said. But in part because health plans are shifting more of the burden to their customers, “the polling this year very clearly shows we are in a health-care affordability crisis, and consumers are facing a big squeeze on their finances,” he said. (Goldstein, 12/5)

Other observers argued that healthcare spending growth remains too high, with inflation-adjusted growth of 2.5% only slightly behind GDP growth of 2.9%. They say that while efforts by payers and providers to control costs may have moderated spending increases, there is still a long way to go to make healthcare affordable and worth the money. "I suppose it's a good sign that healthcare's percentage of total GDP dropped. It's not squeezing out as much spending on other things, but it's still squeezing out a lot," said Steve Wojcik, vice president of public policy for the National Business Group on Health. (Meyer, 12/5)

In the Democratic fight over "Medicare for All" and in the push to lower health care costs in general, hospitals usually fly under the radar, as politicians tend to focus on drug companies and insurers. But the report shows hospitals make up a much larger share of health care spending than drug companies. (Weixel, 12/5)

Kaiser Health News: KHN’s ‘What The Health?’: We Spend HOW MUCH On Health Care?

Health spending in the U.S. grew to $3.6 trillion in 2018, according to a new report from the federal government. The rate of growth — 4.6% — was up slightly from 2017’s 4.2%, despite the fact that nearly a million more Americans lacked insurance. Meanwhile, Congress has less than two weeks to finish a year’s worth of work, including the spending bills required to keep the government running and promised legislation to address “surprise” medical bills and prescription drug prices. (12/5)

Veritas Genetics, the Boston-based personal genome testing company co-founded by noted Harvard Medical School professor George Church, suspended its operations in the United States, according to a statement the company posted Thursday on Twitter. The company experienced “an unexpected adverse financing situation,” according to the posted statement. “We are currently assessing all paths forward, including strategic options.” (Sheridan, 12/5)

The company also laid off the bulk of its employees based in the U.S., about 50 people, earlier this week, according to a source familiar with the company. The source asked not to be named because they were not authorized to speak for Veritas Genetics. “I can clarify this temporarily affects U.S. operations only,” a spokesperson for the company said. “All of the customers outside of the U.S. will continue to be served by Veritas Europe and Latin America.” (Farr, 12/5)

Sue Desmond-Hellmannn is stepping down as CEO of the Bill and Melinda Gates Foundation, the world’s largest funder of biomedical research. In a statement, she cited health and family reasons for the move. Desmond-Hellmann will be replaced by Mark Suzman, the foundation’s president of global policy and advocacy and chief strategy officer, on Feb. 1. (Branswell, 12/5)

Miami-based primary care provider ChenMed plans to expand into the Cleveland market, as well as into Cincinnati, Memphis, Orlando and St. Louis, while growing within its current 14 markets. ChenMed announced Tuesday, Dec. 3, that it plans to establish multiple Dedicated Senior Medical Centers in each of the five new cities, opening a total of 20 new medical practices in the next year. It aims to transform primary care for tens of thousands of presently underserved seniors, according to a news release. (Coutré, 12/5)

Carlos Gregorio Hernandez Vasquez, a 16-year-old Guatemalan migrant, was seriously ill when immigration agents put him in a small South Texas holding cell with another sick boy on the afternoon of May 19. A few hours earlier, a nurse practitioner at the Border Patrol’s dangerously overcrowded processing center in McAllen had diagnosed him with the flu and measured his fever at 103 degrees. She said that he should be checked again in two hours and taken to the emergency room if his condition worsened. None of that happened. Worried that Carlos might infect other migrants in the teeming McAllen facility, officials moved him to a cell for quarantine at a Border Patrol station in nearby Weslaco. By the next morning, he was dead. (Moore, Schmidt, and Jameel, 12/5)

Following Mr. Hernandez Vasquez’s death, a news release stated that he was discovered by federal agents during a welfare check. But a video recording provided by the Police Department in Weslaco, Texas, which initially investigated the case, shows that his death was flagged by his cellmate. Customs and Border Protection officials have not explained why the recording — in which the teenager vomits blood on the floor, his body crumpling and squirming in apparent distress — has a four-hour gap or why the nurse practitioner’s advice was ignored.(Dickerson, 12/5)

According to Border Patrol information, an officer conducted three so-called "welfare checks" on Hernández Vásquez during the four-hour gap in footage. Customs and Border Protection (CBP), which oversees Border Patrol officers, has not explained the missing footage.In addition to documenting Hernández Vásquez's last hours, the footage shows that his cellmate, the other migrant boy, was the one who first found his body. In May, CBP said he "was found un-responsive this morning during a welfare check." (Montoya-Galvez and Kates, 12/5)

Already, President Trump has faced withering criticism for the thousands of family separations it conducted under a “zero tolerance” policy at the southern border and the squalid conditions under which it detained parents and children earlier this year. U.S. Customs and Border Protection issued a statement Thursday saying it could not discuss specifics of the teen’s death due to an ongoing investigation, but that the agency and the Department of Homeland Security “are looking into all aspects of this case to ensure all procedures were followed.” (12/6)

A divided federal appeals court has lifted several injunctions blocking the Trump administration from implementing a rule aimed at limiting immigration benefits for individuals who participate in government programs such as food stamps or Medicaid. In an order Thursday, a three-judge panel of the 9 th Circuit Court of Appeals voted, 2-1, to stay preliminary injunctions issued by federal judges in Oakland, Calif., and Spokane, Wash., against the newly issued “public charge” policy just before it was to take effect in October. (Gerstein, 12/5)

U.S. officials jailed approximately 2,100 pregnant women for immigration violations in 2018, including hundreds who were held for weeks or longer, bringing the increase since President Trump took office to 52 percent, according to a Government Accountability Office report released Thursday. The spike in pregnant detainees came after federal officials terminated an Obama administration order to release most expectant mothers because of health concerns. (Sacchetti, 12/5)

At a time when researching family history is booming, the nation’s immigration and citizenship agency has proposed dramatically hiking fees to access records from the first half of the 20th century. The move has outraged professional and amateur genealogists, who argue that the increase would effectively put valuable immigration information out of reach for many. The fees would nearly triple, and in many cases, they would rise nearly 500 percent, from $130 to $625 to obtain a single paper file. (Trent, 12/5)

Opposition is mounting against a proposal from a Stone Mountain pastor to open a shelter in Marietta to house unaccompanied immigrant children seized at the U.S.-Mexico border.Mitchell Bryant, a pastor and managing partner with the non-profit Freemont Grace Human Services, wants to use a vacant building at 119 Powers Ferry Road to house up to 50 children in custody of the U.S. Department of Health and Human Services. Bryant obtained approval in October from the city’s Zoning Board of Appeals to use the building as a shelter. (Dixon, 12/5)

The House will hold a showdown vote next week on Speaker Nancy Pelosi's bill empowering Medicare to negotiate drug prices, expanded Thursday to provide seniors with dental, vision and hearing benefits not currently covered. Leading Democratic committee chairmen said the Congressional Budget Office has indicated that Pelosi's bill would save the government $500 billion over 10 years, which they pledged to use for new Medicare benefits and other health care priorities such as the National Institutes of Health and the opioid crisis. (Alonso-Zaldivar, 12/5)

“We are going to give Medicare the power to negotiate lower drug prices, and make those prices available to Americans with private insurance as well as Medicare beneficiaries,” Pelosi said in a statement along with Majority Leader Steny Hoyer (D-Md.) and three key committee chairmen, Reps. Frank Pallone Jr. (D-N.J.), Richard Neal (D-Mass.) and Bobby Scott (D-Va.). “American seniors and families shouldn’t have to pay more for their medicines than what Big Pharma charges in other countries for the same drugs.” (Sullivan, 12/5)

Left unclear is whether there will be a complete score of the projected savings from the legislation prior to the vote. Pelosi's office has said leaders wanted a full score before bringing the bill to the floor. The Congressional Budget Office to date has evaluated only the part of the bill, which allows for direct government negotiation of some Medicare drug prices. “We have now received enough guidance from CBO to bring the Lower Drug Costs Now Act to the Floor and to reinvest its savings in one of the most transformation improvements to Medicare since its creation," Pelosi, Majority Leader Steny Hoyer and Reps. Frank Pallone (D-N.J.), Richard Neal (D-Mass.) and Bobby Scott (D-Va.) said in a statement. (Karlin-Smith, 12/5)

The co-chairman of the Congressional Progressive Caucus warned Thursday that some progressive lawmakers might vote against Speaker Nancy Pelosi’s (D-Calif.) bill to lower drug prices unless changes are made. “We have told leadership that there could be people who vote against the bill so they should be ready for that if things aren't included,” Rep. Mark Pocan (D-Wis.) told reporters after a meeting of the Progressive Caucus on Thursday, adding that the group had not done a formal vote count. (Sullivan, 12/5)

President Donald Trump has personally tried to settle the long-running feud between his two top health appointees, telling his health secretary to fix the relationship with his Medicare chief, said three individuals with knowledge of the situation. Trump and Seema Verma, who runs the Centers for Medicare and Medicaid Services, privately met in mid-November amid escalating tensions between her and Health and Human Services Secretary Alex Azar, according to two sources familiar with the meeting. Around the same time, Trump instructed Azar to smooth things over. Those conversations came shortly before POLITICO first reported on the souring relationship between Azar and Verma, whose agency sits within HHS. (Diamond, Pradhan and Cancryn, 12/5)

Nicolas Talbott, a graduate student at Kent State University in Ohio who is transgender, was told in May that because of President Trump’s transgender ban in the military, he would no longer be eligible for placement as an Army officer. He could continue participating in the Reserve Officers Training Corps program, but the benefits that he joined for — health insurance and student loan forgiveness — were no longer available to him. “Everyone else would walk away with a job in the United States Army, and I would walk away with just more student loan debt,” Mr. Talbott said. (Fadulu, 12/6)

As the U.S. Supreme Court prepares to hear a new landmark abortion case, hundreds of lawyers and legal professionals who have had the procedure filed an amicus brief Monday in support of overturning a restrictive Louisiana law. The 368 signers — now partners at top-10 law firms, counsel to Fortune 100 companies, public defenders, prosecutors, retired judges, award-winning professors and current law students — “speak for many more of the past, present, and future members of the legal profession who have, like one in four American women, terminated a pregnancy in their lifetimes,” the filing stated. (Paul, 12/5)

Planned Parenthood is targeting Republican senators in a seven-figure ad campaign over the Trump administration's changes to a federally funded birth control program. The campaign, which will include ads on television, radio and digital platforms, as well as mailers, will target three Republican incumbents who Democrats hope to defeat in 2020: Sens. Cory Gardner (R-Colo.), Martha McSally (R-Ariz.) and Thom Tillis (R-N.C.). (Hellmann, 12/5)

A study designed to test the effectiveness of a controversial practice known as "abortion pill reversal" has been stopped early because of safety concerns. Researchers from the University of California, Davis, were investigating claims that the hormone progesterone can stop a medication-based abortion after a patient has completed the first part of the two-step process. (Gordon, 12/5)

The Supreme Court meets Friday to consider for the first time whether the Constitution gives homeless people a right to sleep on the sidewalk. The justices are weighing an appeal of a much-disputed ruling by the 9th Circuit Court of Appeals that held last year that it was cruel and unusual punishment to enforce criminal laws against homeless people who are living on the street if a city doesn’t offer enough shelters as an alternative. (Savage, 12/5)

California has had enough with its homeless problem. The liberal stronghold is losing patience with the sprawling homeless encampments, the growing ranks of people with mental illnesses and substance abuse on the streets, and the deteriorating quality of life that comes with it — human waste, trash and open-air drug dealing. (Colliver, 12/5)

Los Angeles city officials won a key battle Thursday over a pair of local laws meant to ease the way for more housing for homeless people, defeating a challenge from a Venice group that sought to overturn the ordinances. Fight Back, Venice! sued the city over the two ordinances, arguing the city flouted state law when it approved the local laws. Then state lawmakers stepped in, exempting the L.A. ordinances from the California law at the heart of the case. (Reyes, 12/5)

Democratic presidential contender Michael Bloomberg unveiled a gun control policy on Thursday just steps from the site of one of Colorado's worst mass shootings, calling for a ban on all assault weapons, mandatory permits for gun purchasers and a new position in the White House to coordinate gun violence prevention. “I’ve been all in on the fight against gun violence for 15 years, and I’m just getting started,” Bloomberg declared. “As president, I will work to end the gun violence epidemic once and for all." (Peoples, 12/5)

Mr. Bloomberg, the former mayor of New York City and the most recent entrant in the race for the Democratic presidential nomination, paired the policy announcement with a visit to Aurora, Colo., the site of a 2012 massacre at a movie theater that left a dozen people dead and many more injured. He appeared with State Representative Tom Sullivan of Colorado, whose son was killed in the Aurora shooting. Mr. Sullivan, a Democrat, was elected to the Legislature in 2018, unseating an incumbent Republican. Mr. Sullivan said in an interview that he was endorsing Mr. Bloomberg for president because he trusted him above all the other candidates to wage a fight for stricter gun laws. (Burns, 12/5)

“We have to make sure that we build for the future so no one else has to go through this,” he said. “And I want to say how grateful I am for your leadership. You are making the world a better place and hopefully we don't have to have that many more meetings like this one.” Since entering the Democratic presidential primary last month, Bloomberg has been amplifying his gun control record as he seeks to win over a party that hasn’t settled on a frontrunner. Gun control is a popular issue with the left flank of the party that is otherwise distrustful of the former New York City mayor’s vast wealth — an estimated $54.7 billion — and routine financial support of Republicans over the years. (Goldenberg, 12/5)

House Speaker Nancy Pelosi said Thursday that the process of improving the Affordable Care Act "may lead to 'Medicare for All,' " suggesting that she could prove amenable to the health care proposal that has become a rallying cry for many progressives. The comments highlighted the speaker's shifting tone in addressing the relationship between the two plans supported by Democrats. (Kelly, 12/6)

Tufts University removed the Sackler name from five facilities and programs on Thursday over the family’s role in the opioid epidemic, a gesture aimed at distancing the institution from a pharmaceutical dynasty closely tied to the school for 40 years. The Sacklers’ company, Purdue Pharma, the producer of the prescription painkiller OxyContin, has been cast by prosecutors and plaintiffs as responsible for an addiction epidemic that has led to the deaths of hundreds of thousands of Americans over the past two decades. (Barry, 12/5)

University officials announced the decision Thursday, ending a relationship that has spanned nearly four decades and brought $15 million to the school’s science and medical programs. Tufts leaders said they considered the issue for more than a year before concluding it is inconsistent with the school's values to display the family's name. “We had to deal with the reality that the Sackler name has become associated with a health care epidemic. Given our medical school’s mission, we needed to reconcile that,” Peter Dolan, chairman of Tufts’ board of trustees, said in an interview. (12/5)

Tufts announced in March that it had tapped former U.S. Attorney for the District of Massachusetts Donald Stern to lead an independent review of the university’s relationship to the Sackler family and Purdue Pharma. In a recently released 34-page report, Stern found no evidence that the family’s combined $15 million in contributions had influenced the university’s various programs. (Lorin and Griffin, 12/5)

The university is not returning money donated by the Sacklers; the gifts will continue to be used for their intended purposes, such as biomedical research. Tufts will create a $3 million endowment to support education, research and other efforts to prevent and treat addiction. It will also create an exhibit about the Sackler family’s history with Tufts, which began in the 1980s, long before OxyContin was introduced, and includes contributions from members of the family unconnected with the drug. (Svrluga, 12/5)

A number of museums and schools have announced this year they would no longer accept donations from the Sacklers. Tufts is going further, joining the Louvre, which in July removed the Sackler name from a wing, in scrubbing the family’s name. No longer will programs and facilities at its health sciences and medical school campus, located in downtown Boston, be named after the Sacklers, who along with Purdue have given roughly $15 million to Tufts since 1980. (Joseph, 12/5)

A New York doctor was convicted on Thursday of accepting thousands of dollars in bribes and kickbacks from Insys Therapeutics Inc in exchange for prescribing his patients an addictive fentanyl spray the drug manufacturer produced. Gordon Freedman was the fourth medical practitioner to face trial on charges stemming from what prosecutors say was a wide-ranging bribery scheme orchestrated by the now-bankrupt drugmaker that helped fuel the U.S. opioid epidemic. (12/5)

Prosecutors said Freedman in 2014 wrote the fourth-highest number of prescriptions for Subsys, a potent painkiller, while he was paid more than any other doctor in bribes. “Dr. Gordon Freedman sold out his patients by prescribing a powerful and dangerous fentanyl opioid in exchange for bribes from the pharmaceutical company that manufactured that drug,” U.S. Attorney Geoffrey S. Berman said in a release. (12/5)

Nearly three people a day died from opioid overdoses in St. Louis last year, according to data released by the National Council on Alcoholism and Drug Abuse. There were 1,080 people who died from opioids in St. Louis and eight surrounding counties, up 30% from the year before. The 2018 count, released this week, marks the 12th consecutive year of rising drug-related fatalities in the region. (Fentem, 12/5)

In the text of the ordinance authorizing a needle exchange in Broward County, commissioners ticked off a list of alarming public health statistics: 1,642 opioid overdoses in 2017, more than 21,000 people living with HIV, 387 heroin- and fentanyl-related deaths in 2018.Needle exchanges are designed to prevent the spread of infectious diseases among drug users by providing clean syringes and help reverse opioid overdoses by distributing naloxone directly to people who use drugs, as well as offering them access to other services like testing for hepatitis. (Conarck, 12/5)

Livingston Parish will not have a needle exchange program any time soon after the parish council decided unanimously to indefinitely table a proposal that would have paved the way for the state to operate such an initiative in the area. Needle exchange programs allow drug users to bring used syringes to a designated facility in exchange for a clean needle, with the intent to curb the spread of disease like HIV and hepatitis A and C. (Kennedy, 12/5)

In 2005, Gilead Sciences notified federal regulators that it was suspending development of a potentially safer, more potent HIV-fighting drug than the one on the market. The company did not restart its Food and Drug Administration application until 2010. Now the five-year delay of a promising drug is at the core of accusations by advocates that Gilead improperly exploited the patent system at the expense of patient health. (Rowland, 12/5)

A company that claims to have the first drug to slow mental decline from Alzheimer's disease made its case to scientists Thursday but left them sharply divided over whether there’s enough evidence of effectiveness for the medicine to warrant federal approval. Excitement and skepticism have surrounded aducanumab since its developers stopped two studies earlier this year because it didn't seem to be working, then did a stunning about-face in October and said new results suggest it was effective at a high dose. (Marchione, 12/5)

The presentation was highly anticipated by investors and physicians, but some weren’t persuaded. “It remains very uncertain whether signals of potential activity within a complex and flawed dataset would be enough to warrant approvability—though we believe [Biogen] incrementally strengthened their argument with an additional new data analysis,” Brian Abrahams, an RBC Capital Markets analyst, said in a note to investors. (Walker, 12/5)

The drug, known as aducanumab, was tested in two identically designed late-stage studies. Biogen had halted both of those trials in March because the drug appeared to have failed. But in October, the company announced that a new analysis reflecting previously unavailable data showed that the drug actually reduced decline in patients with early-stage Alzheimer’s in one of the studies, called Emerge. The other study, called Engage, failed.(Robbins and Herper, 12/6)

An experimental pill from Sage Therapeutics (SAGE) that aimed to treat depression more rapidly than existing drugs failed its first large study in patients in major depression, a significant setback for the firm. The drug, called SAGE-217, did not show a statistically significant, anti-depressive benefit compared with a placebo. (Herper and Feuerstein, 12/5)

Sage Therapeutics Inc.'s share price was cut by more than half Thursday, erasing more than $4 billion in market value after the company said its treatment for depression failed in a late-stage trial. The biopharmaceutical company said Thursday its Phase 3 study of the Sage-217 treatment in adults with major depressive disorder didn’t meet its primary endpoint of a statistically significant improvement in a scale that tracks 17 parameters, including anxiety and paranoia, at day 15. (Sebastian, 12/5)

Eli Lilly’s $8 billion purchase of Loxo Oncology in January wasn’t supposed to be a tech-style acqui-hire. But it’s turning into one. On Thursday, the drug giant announced that it is renaming its early cancer drug development arm Loxo Oncology at Lilly, and that the new unit will be helmed by Josh Bilenker, who had been Loxo’s CEO, along with his whole team from the biotech startup, including Jacob Van Naarden, who was the company’s chief operating officer, and Nisha Nanda, its chief development officer. The group is also hiring Dr. David Hyman, the Memorial Sloan Kettering oncologist who spearheaded the company’s early cancer trials, as chief medical officer. (Herper, 12/5)

Washington has never before been so focused on lowering prescription drug prices. But these biotech investors aren’t worried. “Politics is politics,” Affinity Asset Advisors senior research analyst Patrick Nosker said of drug pricing legislation at a STAT event Tuesday in New York. “The whole political overhang is definitely going to be noise throughout the next year.” (Sheridan, 12/6)

The Medicare Payment Advisory Commission is expected to vote against a pay increase for ambulatory surgical centers next month because they don't provide cost data. Medicare payments to ambulatory surgical centers are probably high enough, MedPAC's staff said at a meeting on Thursday. They found that beneficiaries have reliable access to care and that quality is improving. In addition, ambulatory surgical centers have plenty of access to capital and have experienced strong growth in Medicare revenue—it grew 7.4% from 2017 to 2018. (Brady, 12/5)

Kaiser Health News: Website Errors Raise Calls For Medicare To Be Flexible With Seniors’ Enrollment

Saturday is the deadline for most people with Medicare coverage to sign up for private drug and medical plans for next year. But members of Congress, health care advocates and insurance agents worry that enrollment decisions based on bad information from the government’s revamped, error-prone Plan Finder website will bring unwelcome surprises. Beneficiaries could be stuck in plans that cost too much and don’t meet their medical needs — with no way out until 2021. (Jaffe, 12/6)

Open enrollment ends Saturday, Dec. 7, for Snohomish County’s more than 70,000 Medicare beneficiaries. They have until then to fill out their paperwork. The process can easily get confusing. Brisa Guajardo with Community Health Plan of Washington has answers to frequently asked questions this open enrollment season. (12/5)

Combat experience is often blamed as the root cause of suicidal behavior among veterans. But ongoing Army studies show that many troops with mental-health problems can trace them back to trauma experienced before they joined the military. “There is a significant and growing proportion of soldiers who enter the military with psychiatric disorders, increasing the risk over time for suicide behaviors within the Army,” according to a paper released earlier this year from University of Washington researchers that used data from Army-funded studies. (Kesling, 12/5)

Two decades after concern emerged about a class of chemicals used in everything from Teflon pans to firefighting foam, the federal government has started the first in a series of detailed studies of the impact the chemicals have had on human health. The goal is to determine what role the chemicals, known generally as PFAS, play in a long list of health conditions including thyroid, kidney, liver, cardiovascular and autoimmune diseases, among other ailments. (Lipton, 12/5)

Scientists know that if they transfuse blood from a young mouse to an old one, then they can stave off or even reverse some signs of aging. But they don't know what in the blood is responsible for this remarkable effect. Researchers now report that they've identified hundreds of proteins in human blood that wax and wane in surprising ways as we age. The findings could provide important clues about which substances in the blood can slow aging. (Harris, 12/5)

Add facial cuts, bruises and fractures to the risks from cellphones and carelessly using them. That's according to a study published Thursday that found a spike in U.S. emergency room treatment for these mostly minor injuries. The research was led by a facial plastic surgeon whose patients include a woman who broke her nose when she dropped her phone on her face. (12/5)

What if a clock did a better job than a scale at promoting weight loss, improving sleep and preventing diabetes? New research suggests it’s about time to consider that possibility. In an early effort to explore the benefits of daily fasting in humans, researchers have found that people who are at high risk of developing diabetes improved their health in myriad ways when they ate all of their meals over a span of just over 10 hours, then fasted for the remainder of their 24-hour day. (Healy, 12/5)

Kaiser Health News: Black Mothers Get Less Treatment For Postpartum Depression Than Other Moms

Portia Smith’s most vivid memories of her daughter’s first year are of tears. Not the baby’s. Her own. “I would just hold her and cry all day,” Smith said. At 18, Smith was caring for two children, 4-year-old Kelaiah and newborn Nelly, with little help from the partner in her abusive relationship. The circumstances were difficult, but she knew the tears were more than that. (Feldman and Pattani, 12/6)

After decades of progress against one of the most contagious human viruses, the world is seeing measles stage a slow, steady comeback. The World Health Organization and the CDC say in a new report that there were nearly 10 million cases of measles last year, with outbreaks on every continent.An estimated 140,000 people died from measles in 2018, WHO says, up from an all-time low of 90,000 in 2016. (Beaubien, 12/5)

Now that the #MeToo movement has brought conversations about toxic masculinity and sexual consent to the forefront of public discourse, parents are grappling with how to encourage their sons to reject some of the more traditional notions of manhood. But many say they struggle with reinforcing those values in a society that still largely adheres to deeply-rooted stereotypes. It raises the question: How do we raise our boys? (12/4)

Premature babies are at increased risk for diabetes, a large new study reports. In previous studies, preterm birth has been associated with insulin resistance, but this is the first large study to track the risks of diabetes from childhood into adulthood. The researchers followed 4,193,069 singleton babies born in Sweden from 1973 to 2014 for an average of 23 years, some as long as 43 years. (Bakalar, 12/5)

When Mary Prehoden gets dressed for work every morning, her eyes lock on the bite-shaped scar on her chest. It’s a harsh reminder of one of the worst days of her life. Prehoden, a nurse supervisor at Scripps Mercy Hospital San Diego, was brutally attacked last year by a schizophrenic patient who was off his medication. He lunged at her, threw her to the ground, repeatedly punched and kicked her, and bit her so hard that his teeth broke the skin and left her bleeding. (De Marco, 12/5)

Nearly one in three high school students has reported using a tobacco product recently, according to a new federal survey released on Thursday, evidence that concerns over nicotine addiction among teenagers are not limited to e-cigarettes. “The data released today on youth tobacco product use are deeply troubling and indicate that past progress in reducing youth use of these products has been erased,” said Brian King, the deputy director of the Office on Smoking and Health at the Centers for Disease Control and Prevention. “These troubling rates of use are being driven by e-cigarettes, which have no redeeming aspects among youth.” (Hoffman and Kaplan, 12/5)

The findings also show that many of the young people who tried e-cigarettes for the first time said they did so because they were curious. Witnessing their family or friends try e-cigarettes, as well as interest in flavors such as fruit, mint, candy or chocolate were other reasons. In addition, tobacco advertising played a huge role. Nearly 9 in 10 middle and high school students reported exposure to tobacco product advertisements or promotions from at least one source. (Weixel, 12/5)

“Our nation’s youth are becoming increasingly exposed to nicotine, a drug that is highly addictive and can harm brain development,” CDC Director Robert Redfield said in a release. Last year’s data — showing a reversal in two decades of declining tobacco use — propelled a sweeping proposal from then-FDA Commissioner Scott Gottlieb to curb sales of sweet and fruit-flavored e-cigarettes in stores and on websites that cannot verify buyers’ age. “In order to close the on-ramp for kids, we are going to have to narrow the off-ramp for adults,” Gottlieb said at the time. (Owermohle, 12/5)

Six Massachusetts patients with probable — but not confirmed — cases of vaping-related lung illnesses reported using regulated products from state-licensed marijuana companies, state health officials revealed Thursday night. The patients represent a small fraction of the 90 probable and confirmed cases of vaping-related lung illnesses flagged so far by the state Department of Public Health, but mark the first time state authorities have explicitly linked the lung illnesses to cannabis vapes purchased at legal stores and dispensaries. (Adams, 12/5)

The cars with Massachusetts license plates pull into gas stations and vape shops here steadily every day, the people inside them ready to stock up on electronic cigarettes they can’t buy at home. Along the border in New Hampshire and Maine, sales of nicotine and cannabis vaping products have boomed since Sept. 24, when Massachusetts Governor Charlie Baker banned both amid an outbreak of vaping-related lung injuries. At Stoner & Co., a cannabis dispensary in Biddeford, Maine, vape sales rose 76 percent. At Arcus Vapors in Nashua, sales of e-cigarette liquids and equipment have doubled. (Martin, 12/4)

U.S. health officials on Thursday reported one new case and one more death from a respiratory illness tied to vaping, taking the total death toll to 48. As of Dec. 4, 2019, there were 2,291 cases of hospitalized cases reported to the Centers for Disease Control and Prevention (CDC) from 50 states, the District of Columbia, and two U.S. territories. (12/5)

Kellyanne Conway, a top adviser to President Trump, said Thursday that Trump is trying to strike a balance on regulating e-cigarette flavors that preserves the products for adults but keeps them from children. "He's looking for a way to respect and recognize and accommodate the fact that e-cigarettes have a public health benefit for those legal adult users who are trying to come down from combustibles [cigarettes]," Conway told reporters. (Hellmann, 12/5)

The laws are still on the books in Virginia: Blacks and whites must sit in separate rail cars. They cannot use the same playgrounds, schools or mental hospitals. They can’t marry each other either. The measures have not been enforced for decades, but they remain in the state’s official legal record. A state commission on Thursday recommended that dozens of such discriminatory statutes finally be repealed, in some cases more than a century after they were adopted. (12/5)

Many of the laws, some of which are no longer enforced or have been invalidated, stem from the state’s segregationist past, including Jim Crow laws and the Virginia’s Massive Resistance policy, a coordinated effort to thwart federally mandated laws to integrate schools, transportation and neighborhoods. Other laws prohibited interracial marriage and imposed a poll tax designed to prevent black Virginians from voting. “Repeal of these outdated, unjust, and in many cases plainly racist Acts of Assembly is an important step in recognizing and correcting the sins of the past,” Cynthia Hudson, Virginia’s chief deputy attorney general and chair of the governor’s commission, said in a statement. (Rueb, 12/6)

The report groups the laws by topic, illustrating how racism reached into so many areas of daily life — voting, education, health, transportation, housing and criminal justice. “We know that in Virginia, our history is difficult and extremely complex,” Northam said. “And we know that discrimination, racism and black oppression marched on, even after slavery ended. In the form of Jim Crow laws, massive resistance [to school integration] and now among other things, mass incarceration.” (Vozzella, 12/5)

Rosa Diaz was no stranger to hunger and stress and a throbbing pain in the gut that was usually nothing serious — gastritis, she had been told, or lactose intolerance. When she became ill on the evening of Jan. 6, 2015, she figured it was the hot chocolate she’d been drinking with her family to celebrate El Día de los Reyes. It was made with milk, but she finished it anyway, savoring every drop. In the middle of the night, her oldest daughter, Diana, found her on the couch, clutching her belly and moaning. Diana half-carried her to the bathroom, offering her some Alka-Seltzer and a sip of Gatorade to wash the antacid down. Rosa started to shiver and cry. (Martin and Belluz, 12/6)

The parents of a 3-year-old who died after heart surgery at North Carolina Children’s Hospital in 2016 are suing the institution, saying it failed to disclose internal concerns about the quality of its care. Tasha and Thomas Jones, the parents, also allege that doctors didn’t warn them about problems with the heart surgery program, and “instead chose to protect their own reputational and monetary interests” by continuing to refer patients to the Chapel Hill hospital, according to a complaint filed on Thursday in North Carolina state court. (Gabler, 12/5)

Connecticut hospitals will receive $1.8 billion in state and federal funds between now and 2026 to resolve a lawsuit that could have cost the state as much as $4 billion, according to details released Thursday by Gov. Ned Lamont. The agreement includes a one-time payment of $79 million to the industry, along with steadily declining taxes on hospitals — and increasing state payments to facilities — between now and 2026. (Phaneuf, 12/5)

The behavior of a prominent UCLA Health gynecologist during an exam with a married mother of four amounted to sexual assault and harassment, according to an investigative report by the university made public Thursday. It took UCLA almost two years to complete the investigation into allegations raised by a patient against Dr. James Heaps, a 63-year-old physician who was arrested in June on sexual battery and exploitation charges. (Cosgrove, 12/5)

The new head of the Minnesota Department of Human Services (DHS) has filled several key management positions in her ongoing effort to address leadership turmoil and financial missteps that have wracked the $18.5 billion agency since the summer. Human Services Commissioner Jodi Harpstead announced the appointment of two top administrators Thursday to oversee the Community Supports Administration, a large and complex branch that oversees services for about 500,000 Minnesotans. The area has a $393 million annual budget and includes mental health, substance use disorder services, housing supports and disability services. (Serres, 12/5)

Registered nurses at Sierra Nevada Memorial Hospital in Grass Valley will be doing informational picketing outside the facility Dec. 13 to alert community residents to staffing changes that are making it hard for them to provide timely patient care. (Anderson, 12/5)

Gov. Ron DeSantis has proposed creating a program that would increase funding for high-performing hospitals, a move that could mean more money for 66 hospitals across Florida, including Tampa General, according to an analysis by a statewide hospital association. The Medicaid proposal — dubbed the Top Outcome for Patients, or TOP, program — was included in the $91.4 billion budget plan DeSantis’ unveiled last month. DeSantis recommended spending $3.8 million on the initiative. When matched with federal funding, that would make available nearly $10 million. (12/6)

A coastal North Carolina hospital has joined a selective network associated with Mayo Clinic. Carteret Health Care is the first health care facility in the state to have joined the Mayo Clinic Care Network, granting it access to expert consultations and other services. “It’s not a merger … they [Mayo] don’t want that, [and] our board, our management doesn’t want that,” said Dick Brvenik, who heads the Morehead City hospital. “We’re in the relationship so we can improve our quality, improve our performance as a high-quality, independent hospital and health network, that’s what we want and that’s what we’re getting.” (Engel-Smith, 12/6)

A group representing prisoners with disabilities is accusing the Florida Department of Corrections of failing to comply with a settlement reached in a federal lawsuit about discrimination against inmates who are deaf, blind or use wheelchairs. Under the settlement finalized in June 2017, the state agreed, among other things, to provide sign-language interpreters for deaf prisoners and to remove architectural barriers for inmates who use wheelchairs. (Kam, 12/5)

Several hospitals in Montgomery County offer volunteer programs for adults and high school students. They have become an integral part of the hospital’s daily operations down to manning the small gift shops. Memorial Hermann The Woodlands, MD Anderson The Woodlands, Texas Children’s The Woodlands, Houston Methodist The Woodlands and CHI St. Luke’s Health-The Woodlands believe that volunteers play an essential role in giving that extra-special attention and care for their patients. (Hashmi, 12/5)

Rosario Hernandez regularly gardens with her grandchildren at her two Atlanta properties in the English Avenue district, about a mile from Mercedes-Benz Stadium. So Hernandez, who works with Historic Westside Gardens, was alarmed when an Emory University team analyzed the soil in July 2018 and discovered it contained unsafe concentrations of lead — a potent neurotoxin that is especially dangerous to children. (Miller, 12/5)

A 23-year-old Chicago man who received two heart transplants as a teenager died in hospice care, days after he married his high school sweetheart, his new bride said. Javier Rodriguez was diagnosed in seventh grade with dilated cardiomyopathy, a genetic disease that predisposes victims to develop heart failure at a young age. Rodriguez, known to his family and friends as Javi, underwent two heart transplants, including one when he was 14 years old and another when he was 18. (12/5)

By the end of 2019, police expect 150 homicides in Kansas City, most at the point of a gun. Authorities say another 500 people will be shot and wounded. Many of the survivors, plus their families and neighbors, will spend the rest of their lives dealing with the aftermath of a gunshot wound. A new program is seeking to give people the help they need to heal both their physical and mental wounds. (Zeff, 12/5)

About 22,000 patients now have the OK from Missouri to use medical marijuana cards, but they won’t have anywhere to legally buy the drug for almost two more months, state health officials said Thursday. Licenses for dispensaries won’t be issued until about Jan. 24, Missouri’s Department of Health and Senior Services’ Section for Medical Marijuana Regulation said in a statement. (Gutierrez, 12/5)

When a presidential race that was supposed to be won by a mainstream moderate instead ends being captured by a far-right gadfly, you better believe pollsters are gonna get some scrutiny. But when this situation took place in the first round of French elections in 2002, bumping the incumbent prime minister from the final round, it wasn’t just the failure of prediction that led to a polling protest. Instead, people were concerned that opinion polling, itself, had caused the outcome. Twenty-four years earlier, France had muzzled opinion polling, banning the publication of poll results for a week before any election out of fear that voters were following the polls, rather than the other way around. (Koerth, 12/5)

A thousand seemingly insignificant things change as an organism ages. Beyond the obvious signs like graying hair and memory problems are myriad shifts both subtler and more consequential: Metabolic processes run less smoothly; neurons respond less swiftly; the replication of DNA grows faultier. But while bodies may seem to just gradually wear out, many researchers believe instead that aging is controlled at the cellular and biochemical level. They find evidence for this in the throng of biological mechanisms that are linked to aging but also conserved across species as distantly related as roundworms and humans. Whole subfields of research have grown up around biologists’ attempts to understand the relationships among the core genes involved in aging, which seem to connect highly disparate biological functions, like metabolism and perception. (Greenwood, 11/30)

In clinics around the world, a type of artificial intelligence called deep learning is starting to supplement or replace humans in common tasks such as analyzing medical images. Already, at Massachusetts General Hospital in Boston, “every one of the 50,000 screening mammograms we do every year is processed through our deep learning model, and that information is provided to the radiologist,” says Constance Lehman, chief of the hospital’s breast imaging division. In deep learning, a subset of a type of artificial intelligence called machine learning, computer models essentially teach themselves to make predictions from large sets of data. The raw power of the technology has improved dramatically in recent years, and it’s now used in everything from medical diagnostics to online shopping to autonomous vehicles. (Bender, 12/4)

Champagne flutes were hastily unpacked from boxes, filled to their brims and passed around the room. Dozens of people stood around inside Marieke Vervoort’s cramped apartment, unsure of what to say or do. This was a celebration, Vervoort had assured her guests. But it did not feel like one. Eleven years earlier, Vervoort had obtained the paperwork required to undergo doctor-assisted euthanasia. Since her teenage years she had been battling a degenerative muscle disease that stole away the use of her legs, stripped her of her independence, and caused her agonizing, unrelenting pain. The paperwork had returned some sense of control. Under Belgian law, she was free to end her life anytime she chose. (Addario, 12/5)

My mornings are the messiest part of my day. I do not rise and shine. Instead, I hit snooze on the alarm and throw the covers over my head. As I hear the early bus shuffle through my stop outside my window, my mind fills with thoughts from the night before, with to-do lists and deadlines. The alarm goes off again, and I repeat the snooze cycle twice more. By the time I roll out of bed, I’m a tangle of anxiety. (Koren, 12/2)

Doctors told my wife there was “very little chance” her breast cancer would return. But five years later, three months after Paula’s 51st birthday, I typed “prognosis of metastatic breast cancer” into my browser and through tears read the search results: “dismal prognosis,” “incurable,” “median survival of three years.” Paula’s doctors urged us not to despair — there were great new medicines available they hoped could slow down the tumor. And now, three years later, her cancer has not progressed. As a husband, I’m obviously ecstatic. As a physician who studies health economics, I find myself wondering: Can we, as a society, afford to pay for the kind of medicines that have kept my wife’s cancer at bay? (Peter Ubel, 12/6)

Over the past five years, prescription drug prices have climbed at 10 times the rate of inflation, leaving one in four Americans unable to afford their medications. Across my district in the East Bay, I often hear stories from my constituents about how the rising price of prescription drugs has forced many to make impossible decisions about whether to pay for their medications or for other necessities like groceries and rent. (Mark DeSaulnier, 12/4)

No drug for Alzheimer’s disease does anything but treat symptoms of the degenerative ailment. The first medicine that can do more will be an enormous breakthrough. Biogen Inc. thinks it has that drug in aducanumab. It’s a treatment the company previously announced was a failure in March, but in a highly unusual move, it is trying to resurrect the medicine and gambling that it can win Food and Drug Administration approval. The company presented an expanded case for the medication at a medical meeting on Thursday. (Max Nisen, 10/5)

A decade ago, Edward O. Wilson, the Harvard professor and renowned father of sociobiology, was asked whether humans would be able to solve the crises that would confront them over the next 100 years. “Yes, if we are honest and smart,” he replied. “The real problem of humanity is the following: We have Paleolithic emotions, medieval institutions and godlike technology.” Since Mr. Wilson’s observation, technology’s godlike powers have increased dramatically, while the ancient, Paleolithic impulses of our brains have remained the same. (Tristan Harris, 12/5)

One crucial missing piece to the devastating puzzle of Alzheimer’s disease and other types of dementia is how to detect them early. Many researchers are hard at work evaluating biomarkers like levels of proteins known as beta-amyloid and tau in cerebrospinal fluid or imaging-detected changes in the brain. There might be another, easier-to-detect signal. The first clinical markers of cognitive decline are found not in the brain but in the bank account. Impaired financial decision-making can appear decades before the emergence of other traditional signs or symptoms, like memory loss. (Eric Chess, 12/5)

More than 140,000 people died last year from measles. That’s the headline coming out of the U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) today. It’s staggering; in our modern age, absolutely no one should die from measles — a disease we can prevent with a safe, effective vaccine that costs roughly two dollars. Our government must do more to make the vaccine as widespread globally as the measles virus is itself.  (Kate Dodson, 12/5)

Republicans are all about boosting economic growth, so they say. Eking out a few extra bucks of economic activity is their top priority — more important than, say, curbing illness and death (hence, looser water pollution standards, fewer slaughterhouse inspections) or even reducing deficits (hence, those budget-busting tax cuts). Unless it comes to punishing poor people. In which case, even the economy has to take a back seat. (Catherine Rampell, 12/5)

Primary care providers, or PCPs, are the core of quality health care. Building a relationship with a PCP is one of the best ways a person can pursue better health. PCPs get to know their patients, including family history and furture risks. They treat common, non-emergency conditions, help manage chronic health issues and connect patients to specialty care when it’s needed. (Henry Smith, 12/4)

“I can’t do it anymore,” he said, before doing chores and walking out on our marriage. Wait a minute, I thought, who takes out the garbage minutes after declaring their marriage over? After eight and a half years together, a little under four of them as a married couple, my husband decided that he no longer wanted a wife with a disability. Having a partner with a disability is challenging; I get that. I am still the same person at my core, but the disease has changed my ability to walk and slowed my speech. (Brenda Arredondo, 12/5)

Thousands of Tennesseans are in a mental health care gap – which means they have barriers, such as cost and coverage, to accessing services they want and need. I have dedicated thirty years to providing mental health services and alcohol and substance use treatment, and I have seen the negative impacts of that gap in care too often. (Ben Middleton, 12/3)

The bottom line is that banning non-competes for low-wage and hourly workers allows the market for their labor to actually work and their wages to rise. Enforcing non-compete agreements for such workers allows employers to suppress competition for workers’ services and keeps their wages lower. Proposals at the state and federal level to limit the enforceability of non-compete agreements have gone nowhere (i.e., the federal Freedom to Compete Act). (Chris Jenkins, 12/4)